, NURS 5334 PHARMACOLOGY MODULE 8 QUIZ
Advanced Pharmacology for Nurse Practitioners
University of Texas at Arlington (UTA) 100-
Question Original Practice Quiz
2026/2027 Edition
Practice focus: anemia and erythropoiesis, cardiovascular pharmacotherapy, renal pharmacology, hypertension, heart
failure, ischemic heart disease, dyslipidemia, anticoagulation, antiplatelet therapy, antiarrhythmics, diuretics, and medication
safety.
1. A patient with iron-deficiency anemia is prescribed oral ferrous sulfate. Which instruction most
improves absorption?
A) Take it with tea to reduce gastrointestinal upset.
B) Take it with a proton-pump inhibitor to increase acidity.
C) Take it with a source of vitamin C when tolerated.
D) Take it with calcium carbonate at the same time.
Correct Answer: Take it with a source of vitamin C when tolerated.
Rationale:
Ascorbic acid can enhance absorption of nonheme iron by maintaining iron in a more absorbable ferrous state. Calcium,
antacids, and polyphenols in tea can reduce iron absorption. Gastrointestinal adverse effects are common, so timing may
be adjusted for tolerance, but separating iron from absorption-reducing agents remains important.
2. Which finding is most consistent with an expected early response to effective iron replacement in
uncomplicated iron-deficiency anemia?
A) Immediate normalization of ferritin within 24 hours.
B) A rise in the reticulocyte count.
C) Suppression of erythropoietin secretion before hemoglobin rises.
D) A marked fall in mean corpuscular volume within 48 hours.
Correct Answer: A rise in the reticulocyte count.
Rationale:
Reticulocytosis typically appears before full correction of hemoglobin because the marrow begins producing new red cells
soon after adequate iron becomes available. Ferritin and hemoglobin recover more gradually. Mean corpuscular volume
does not rapidly fall with effective therapy; it trends toward normal as newly produced cells enter circulation.
3. A patient taking oral iron reports black stools. What is the best interpretation?
A) This is a common, expected effect of oral iron therapy.
B) It means the dose is ineffective.
C) It confirms gastrointestinal bleeding.
D) It indicates acute iron toxicity.
Correct Answer: This is a common, expected effect of oral iron therapy.
Rationale:
Dark or black stools are a common consequence of oral iron and do not by themselves indicate gastrointestinal bleeding.
The clinician should still assess for alarm symptoms when appropriate, but stool darkening alone is expected. Efficacy is
judged by hematologic response, not stool color.
4. Which laboratory test best reflects body iron stores in most patients with suspected iron deficiency?
A) Serum sodium.
NURS 5334 Module 8 Practice Quiz 1 2026/2027 Edition
, B) Troponin I.
C) Activated partial thromboplastin time.
D) Serum ferritin.
Correct Answer: Serum ferritin.
Rationale:
Ferritin is the most useful routine marker of iron stores, although inflammation can raise ferritin and complicate
interpretation. Sodium, coagulation studies, and cardiac biomarkers do not assess iron storage. Iron deficiency is usually
interpreted with ferritin plus other indices such as transferrin saturation when needed.
5. A patient with severe chronic kidney disease and anemia is being considered for an erythropoiesis-
stimulating agent (ESA). What deficiency should be corrected first if present?
A) Vitamin C excess.
B) Iron deficiency.
C) Low HDL cholesterol.
D) Hypermagnesemia.
Correct Answer: Iron deficiency.
Rationale:
Adequate iron is required for an optimal response to ESAs. Functional or absolute iron deficiency can cause poor
hemoglobin response despite escalating ESA doses. Iron status should therefore be assessed and corrected before or
during ESA therapy, while also addressing other reversible causes of anemia.
6. What is the major safety concern when an ESA raises hemoglobin too aggressively in chronic kidney
disease?
A) Profound neutropenia in all patients.
B) Acute ototoxicity.
C) Increased risk of thrombotic and cardiovascular events.
D) Severe hypoglycemia.
Correct Answer: Increased risk of thrombotic and cardiovascular events.
Rationale:
Higher hemoglobin targets and rapid rises with ESAs have been associated with increased cardiovascular and thrombotic
risk. Treatment therefore uses the lowest effective dose needed to reduce transfusion requirements rather than normalizing
hemoglobin. Glucose, hearing, and neutrophil effects are not the defining dose-limiting concerns.
7. Which adverse effect should be emphasized when counseling a patient starting epoetin alfa?
A) Dry cough from bradykinin accumulation.
B) Orange urine.
C) Hypertension.
D) Gingival hyperplasia.
Correct Answer: Hypertension.
Rationale:
ESAs can increase blood pressure and may worsen preexisting hypertension, so blood pressure monitoring is important.
Orange urine is associated with some urinary analgesics, gingival hyperplasia with certain calcium-channel blockers or
anticonvulsants, and bradykinin-mediated cough with ACE inhibitors.
8. A patient has macrocytic anemia due to vitamin B12 deficiency from pernicious anemia. Which
treatment strategy is most appropriate?
A) Give oral iron as the only therapy.
NURS 5334 Module 8 Practice Quiz 2 2026/2027 Edition
Advanced Pharmacology for Nurse Practitioners
University of Texas at Arlington (UTA) 100-
Question Original Practice Quiz
2026/2027 Edition
Practice focus: anemia and erythropoiesis, cardiovascular pharmacotherapy, renal pharmacology, hypertension, heart
failure, ischemic heart disease, dyslipidemia, anticoagulation, antiplatelet therapy, antiarrhythmics, diuretics, and medication
safety.
1. A patient with iron-deficiency anemia is prescribed oral ferrous sulfate. Which instruction most
improves absorption?
A) Take it with tea to reduce gastrointestinal upset.
B) Take it with a proton-pump inhibitor to increase acidity.
C) Take it with a source of vitamin C when tolerated.
D) Take it with calcium carbonate at the same time.
Correct Answer: Take it with a source of vitamin C when tolerated.
Rationale:
Ascorbic acid can enhance absorption of nonheme iron by maintaining iron in a more absorbable ferrous state. Calcium,
antacids, and polyphenols in tea can reduce iron absorption. Gastrointestinal adverse effects are common, so timing may
be adjusted for tolerance, but separating iron from absorption-reducing agents remains important.
2. Which finding is most consistent with an expected early response to effective iron replacement in
uncomplicated iron-deficiency anemia?
A) Immediate normalization of ferritin within 24 hours.
B) A rise in the reticulocyte count.
C) Suppression of erythropoietin secretion before hemoglobin rises.
D) A marked fall in mean corpuscular volume within 48 hours.
Correct Answer: A rise in the reticulocyte count.
Rationale:
Reticulocytosis typically appears before full correction of hemoglobin because the marrow begins producing new red cells
soon after adequate iron becomes available. Ferritin and hemoglobin recover more gradually. Mean corpuscular volume
does not rapidly fall with effective therapy; it trends toward normal as newly produced cells enter circulation.
3. A patient taking oral iron reports black stools. What is the best interpretation?
A) This is a common, expected effect of oral iron therapy.
B) It means the dose is ineffective.
C) It confirms gastrointestinal bleeding.
D) It indicates acute iron toxicity.
Correct Answer: This is a common, expected effect of oral iron therapy.
Rationale:
Dark or black stools are a common consequence of oral iron and do not by themselves indicate gastrointestinal bleeding.
The clinician should still assess for alarm symptoms when appropriate, but stool darkening alone is expected. Efficacy is
judged by hematologic response, not stool color.
4. Which laboratory test best reflects body iron stores in most patients with suspected iron deficiency?
A) Serum sodium.
NURS 5334 Module 8 Practice Quiz 1 2026/2027 Edition
, B) Troponin I.
C) Activated partial thromboplastin time.
D) Serum ferritin.
Correct Answer: Serum ferritin.
Rationale:
Ferritin is the most useful routine marker of iron stores, although inflammation can raise ferritin and complicate
interpretation. Sodium, coagulation studies, and cardiac biomarkers do not assess iron storage. Iron deficiency is usually
interpreted with ferritin plus other indices such as transferrin saturation when needed.
5. A patient with severe chronic kidney disease and anemia is being considered for an erythropoiesis-
stimulating agent (ESA). What deficiency should be corrected first if present?
A) Vitamin C excess.
B) Iron deficiency.
C) Low HDL cholesterol.
D) Hypermagnesemia.
Correct Answer: Iron deficiency.
Rationale:
Adequate iron is required for an optimal response to ESAs. Functional or absolute iron deficiency can cause poor
hemoglobin response despite escalating ESA doses. Iron status should therefore be assessed and corrected before or
during ESA therapy, while also addressing other reversible causes of anemia.
6. What is the major safety concern when an ESA raises hemoglobin too aggressively in chronic kidney
disease?
A) Profound neutropenia in all patients.
B) Acute ototoxicity.
C) Increased risk of thrombotic and cardiovascular events.
D) Severe hypoglycemia.
Correct Answer: Increased risk of thrombotic and cardiovascular events.
Rationale:
Higher hemoglobin targets and rapid rises with ESAs have been associated with increased cardiovascular and thrombotic
risk. Treatment therefore uses the lowest effective dose needed to reduce transfusion requirements rather than normalizing
hemoglobin. Glucose, hearing, and neutrophil effects are not the defining dose-limiting concerns.
7. Which adverse effect should be emphasized when counseling a patient starting epoetin alfa?
A) Dry cough from bradykinin accumulation.
B) Orange urine.
C) Hypertension.
D) Gingival hyperplasia.
Correct Answer: Hypertension.
Rationale:
ESAs can increase blood pressure and may worsen preexisting hypertension, so blood pressure monitoring is important.
Orange urine is associated with some urinary analgesics, gingival hyperplasia with certain calcium-channel blockers or
anticonvulsants, and bradykinin-mediated cough with ACE inhibitors.
8. A patient has macrocytic anemia due to vitamin B12 deficiency from pernicious anemia. Which
treatment strategy is most appropriate?
A) Give oral iron as the only therapy.
NURS 5334 Module 8 Practice Quiz 2 2026/2027 Edition
